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Excellent perinatal outcome of monoamniotic twin pregnancy with timely diagnosis and optimal management – a retrospective cohort study

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Veröffentlicht/Copyright: 4. April 2022
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 50 Heft 5

Abstract

Objectives

Monoamniotic twins represent a high-risk pregnancy requiring intense follow-up, elective birth and careful consideration of the mode and timing of delivery. We conducted this study to evaluate the perinatal and neonatal outcomes of monoamniotic twin pregnancies in the largest tertiary hospital in Finland.

Methods

This was a retrospective cohort study including all monoamniotic twin pregnancies during a 17-year period (2002–2018) managed in Helsinki University Hospital. Data on mothers and children were collected from patient files. Chorionicity and amnionicity were defined in first-trimester ultrasound screening.

Results

There were altogether 31 monoamniotic twin pregnancies during the study period, including four cases of conjoined twins which all underwent termination of pregnancy, and three miscarriages. In the remaining 24 pregnancies that continued past 24 weeks of gestation there was 97.9% survival (one intrauterine death). Three pregnancies were complicated with twin-to-twin transfusion syndrome. All children were delivered by cesarean section with a mean gestational age of 32 + 5 weeks (27 + 1–34 + 2 weeks). Respiratory distress syndrome (RDS) was observed in 57% (27/47) of neonates and grade I–II intraventricular haemorrhage (IVH) in 6.3% (3/47) of neonates. There were no neonatal deaths and no maternal complications.

Conclusions

Monoamniotic twinning is a rare form of pregnancy and carries risks for perinatal and neonatal complications. With timely diagnosis, close monitoring in specialized feto-maternal unit and elective delivery at 32–34 weeks the outcome is usually excellent.

Keywords: monoamniotic; pregnancy; preterm; twins
Corresponding author: Vedran Stefanovic, MD, PhD, Professor, Department of Obstetrics and Gynecology, Vice-President of the IAPM Educational Committee, Fetomaternal Medical Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland, Phone: +358 50 427 1230, E-mail:

  1. Research funding: None declared.

  2. Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013) and has been approved by the authors’ Institutional Review Board (Helsinki University Hospital Obstetrics and Gynecology).

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Received: 2021-11-16
Revised: 2022-01-23
Accepted: 2022-03-04
Published Online: 2022-04-04
Published in Print: 2022-06-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Reviews
  3. Venous thrombosis risk factors in pregnant women
  4. Ethical considerations of maternal-fetal surgery
  5. Opinion Paper
  6. John Stuart Mill is relevant to COVID-19 vaccination in pregnancy today
  7. Corner of Academy
  8. Excellent perinatal outcome of monoamniotic twin pregnancy with timely diagnosis and optimal management – a retrospective cohort study
  9. Original Articles – Obstetrics
  10. Giving birth alone due to COVID-19-related hospital restrictions compared to accompanied birth: psychological distress in women with caesarean section or vaginal birth – a cross-sectional study
  11. COVID-19 and its effect on Instagram adoption by #OBGYN residency programs
  12. The role of the placenta in spontaneous preterm labor and delivery with intact membranes
  13. New ultrasonographic midtrimester scoring method for predicting spontaneous preterm birth in uncomplicated asymptomatic twin pregnancies
  14. Antenatal corticosteroids and neonatal outcomes in preterm birth in the United States
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  16. Maternal and neonatal outcomes among pregnant women with inflammatory myopathies
  17. Outcomes of pregnancies at high-risk for placenta accreta spectrum following negative diagnostic imaging
  18. Risk factors for postpartum hemorrhage in patients with retained placenta: building a predict model
  19. Prediction of insulin therapy in women with gestational diabetes: a systematic review and meta-analysis of observational studies
  20. Timing of delivery in antenatal fetal hydronephrosis: a snap shot social media survery of obstetric and fetal medicine practice
  21. Original Article – Neonates
  22. Is low cerebral near infrared spectroscopy oximetry associated with neurodevelopment of preterm infants without brain injury?
  23. Short Communication
  24. Postpartum depression, mode of delivery, and indication for unscheduled cesarean delivery: a retrospective cohort study
  25. Letters to the Editor
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  27. John Stuart Mill and COVID-19 vaccination
  28. Letter reply “John Stuart Mill and COVID-19 vaccination”
https://doi.org/10.1515/jpm-2021-0612
Schlagwörter für diesen Artikel
monoamniotic; pregnancy; preterm; twins

Artikel in diesem Heft

  1. Frontmatter
  2. Reviews
  3. Venous thrombosis risk factors in pregnant women
  4. Ethical considerations of maternal-fetal surgery
  5. Opinion Paper
  6. John Stuart Mill is relevant to COVID-19 vaccination in pregnancy today
  7. Corner of Academy
  8. Excellent perinatal outcome of monoamniotic twin pregnancy with timely diagnosis and optimal management – a retrospective cohort study
  9. Original Articles – Obstetrics
  10. Giving birth alone due to COVID-19-related hospital restrictions compared to accompanied birth: psychological distress in women with caesarean section or vaginal birth – a cross-sectional study
  11. COVID-19 and its effect on Instagram adoption by #OBGYN residency programs
  12. The role of the placenta in spontaneous preterm labor and delivery with intact membranes
  13. New ultrasonographic midtrimester scoring method for predicting spontaneous preterm birth in uncomplicated asymptomatic twin pregnancies
  14. Antenatal corticosteroids and neonatal outcomes in preterm birth in the United States
  15. Pregnancy, delivery, and neonatal outcomes among women with psoriatic arthritis, a population based study
  16. Maternal and neonatal outcomes among pregnant women with inflammatory myopathies
  17. Outcomes of pregnancies at high-risk for placenta accreta spectrum following negative diagnostic imaging
  18. Risk factors for postpartum hemorrhage in patients with retained placenta: building a predict model
  19. Prediction of insulin therapy in women with gestational diabetes: a systematic review and meta-analysis of observational studies
  20. Timing of delivery in antenatal fetal hydronephrosis: a snap shot social media survery of obstetric and fetal medicine practice
  21. Original Article – Neonates
  22. Is low cerebral near infrared spectroscopy oximetry associated with neurodevelopment of preterm infants without brain injury?
  23. Short Communication
  24. Postpartum depression, mode of delivery, and indication for unscheduled cesarean delivery: a retrospective cohort study
  25. Letters to the Editor
  26. Peripartum cephalocenthesis in a large fetal hydranencephaly
  27. John Stuart Mill and COVID-19 vaccination
  28. Letter reply “John Stuart Mill and COVID-19 vaccination”
Heruntergeladen am 10.5.2026 von https://www.degruyterbrill.com/document/doi/10.1515/jpm-2021-0612/html?lang=de
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